Medicaid -- an Entitlement Absolutely Needed to Protect Both the Poor and the Middle Class

Last week, I was unable to send my commentary because I was in the hospital suffering from anemia requiring three blood transfusions. The reason for the condition was that I had hemorrhaged in my mouth as a result of dental implants and Coumadin, a blood thinner. That affected other parts of my 87-year-old body and the doctors needed to take steps to deal with a water retention issue. After five days in New York-Presbyterian Hospital located in upper Manhattan, I was discharged. I am very grateful to New York-Presbyterian, its doctors, nurses and technicians for all the medical assistance they provided so expertly and I am especially grateful to my cardiologist, Joe Tenenbaum, for attending my medical needs over the last 30 or more years.

While in the hospital, I watched the Democratic National Convention in Charlotte, North Carolina. I had watched the Republican National Convention during the prior week. Both conventions were well worth watching and displayed America at its best. At the Republican convention, the two best performances were provided by Condoleezza Rice and New Mexico Governor Susana Martinez. The personal stories of the women, Rice, an African-American brought up in Jim Crow Birmingham to become U.S. Secretary of State under President George W. Bush, showed that in America, there are opportunities to achieve your goals based on your ability, notwithstanding the discrimination that still exists in our country based on race. Similarly, the story of Governor Martinez and how she succeeded, told so charmingly and humorously, undoubtedly moved the country to tears. It did me.

At the Democratic convention, the two best were President Bill Clinton and Mayor Julian Castro of San Antonio. Bill Clinton's ability to take complicated issues and present them in a way so easily understood is remarkable. He skewered the Republicans. Mayor Castro's personal story and his ebullience and extraordinary smile undoubtedly affected millions watching him.

I am a staunch Democrat and I have always believed the Democratic philosophy, which is to offer a helping hand to those in need, is far preferable to the Republican philosophy of demanding that people make it on their own without assistance. I have not hesitated to cross party lines when I thought my party's candidate for office was not up to the job. For me, our country comes ahead of party. Jack Kennedy put it best when he said that sometimes loyalty to party demands too much.

Fortunately, that is not the case now. The Democratic Party and its candidate, Barack Obama, are far and away better for the country than the Republican Party and its candidate, Mitt Romney. There are many illustrations I could give, but I will highlight only one, a very important one. We all know the Republicans are out to change Social Security and Medicare by privatizing them and ending guaranteed federal funding to keep both programs as entitlement programs -- ones you can count on. The third program -- Medicaid -- is an existing entitlement program operated by the federal government primarily for the poor, which restricts what a state can do in its implementation. The Republicans have said repeatedly through their vice presidential candidate, Paul Ryan, that they will turn the program into a block grant, allowing the states to use the funds as they deem fit. Also, according to a report issued by the Center on Budget and Policy Priorities, "the Ryan budget would shrink federal Medicaid funding by $810 billion -- or 22 percent -- over the next 10 years."

Most people believe Medicaid only applies to the poor and that the middle class's needs are met by Medicare. However, Medicare does not provide for long-term nursing home care. That kind of care now costs $250 to $400 per day. Middle class families are required to spend down their resources before the federal and state governments pick up the nursing home tab. The New York Times of September 6 made clear the effect on the middle class of changing Medicaid from its current role as an entitlement and turning it into a block grant. The article stated:

Medicaid has long conjured up images of inner-city clinics jammed with poor families. Its far less-visible role is as the only safety net for millions of middle-class people whose needs for long-term care, at home or in a nursing home, outlast their resources." The article continued, "Seniors like Rena Lull, 92, who spent the last of her life savings on $250-a-day nursing home care near Cooperstown, N.Y., last year, will face uncharted territory if Republicans carry out their plan to replace Medicaid with block grants that cut spending by a third over a decade. The move would let states change minimum eligibility, standards of care, and federal rules that now protect adult children from being billed for their parents' Medicaid care.

For these reasons alone, President Barack Obama should be reelected and given a majority of Democrats in both houses of Congress.

A final note. I thought it shameful on the part of both candidates for president and both national parties that not a word was said at either convention on ending the Afghanistan war and bringing home our soldiers immediately. Nor did either convention address the prosecution and lack thereof of those who committed criminal acts bringing on the Great Recession. Surely, some delegates at both conventions could have demonstrated and brought proceedings to a halt or attempted the introduction of resolutions on both issues. They didn't, and failed in their responsibilities. Remember the efforts of millions of Americans to end the Vietnam War? What's happened to our willingness to stand up and speak truth to power?